Following a transtibial amputation (TTA), physical activity has known benefits for health and quality of life. Adults post-TTA, however, demonstrate reduced physical activity, predisposing them to adverse health outcomes. Identifying adults at the risk of sedentarism post-TTA via commonly used, objective clinical measures may enhance clinical decisions, including prosthesis prescription. The study’s purpose was to determine whether residual and sound limb hip strength distinguishes between sedentary and nonsedentary adults post-TTA. A secondary analysis of a cross-sectional dataset (n = 44) was conducted. Participant residual and sound limb hip flexion, extension, abduction and adduction strength were assessed via handheld dynamometry. Physical activity was monitored for 7 days and participants were classified as sedentary (<5000 steps/day; n = 13) or nonsedentary (≥5000 steps/day; n = 31). Receiver operating curves revealed that residual and sound limb hip extension, abduction and adduction strength distinguished between sedentary and nonsedentary adults post-TTA (P < 0.050). Preliminary cut-points for hip strength measures to classify adults at the risk of sedentarism were determined. A hip strength composite score (0–6) estimates a 2.2× increased odds of being sedentary with each additional hip strength deficit. Post-TTA, residual and sound limb hip strength can help identify adults at risk of sedentarism to aid clinical decision making, including prosthesis prescription.

Objectives: Postamputation, clinical markers of pain-related peripheral and central nervous system hypersensitivity remain understudied. This study aimed to identify whether adults with postamputation pain demonstrate greater pain sensitivity in primary (ie, amputated region) and secondary (ie, nonamputated region) sites, as compared with painfree peers and controls with intact limbs.Methods: Ninety-four participants postunilateral, transtibial amputation (59 with pain, 35 pain-free) and 39 controls underwent pain-pressure threshold (PPT) testing at 10 sites. Pain-pressure thresholds were normalized to sex-specific control data using Z score conversions. Normalized primary-site and secondary-site PPTs were compared between groups using multivariate analysis of variance (P < 0.050).Results: Compared with pain-free peers, adults with postamputation pain demonstrated reduced normalized PPTs across primary and secondary sites (mean difference = 0.61-0.74, P = 0.001 to 0.007). Compared with controls, adults with postamputation pain demonstrated reduced normalized PPTs (mean difference = 0.52, P = 0.026) only at primary sites.Discussion: Adults with postamputation pain demonstrate greater amputated region pain sensitivity as compared with pain-free peers or controls with intact limbs, indicating peripheral sensitization persists even after limb healing. Secondary-site pain sensitivity was similar between controls and adults with postamputation pain, suggesting central nervous system hypersensitivity may not be ubiquitous with postamputation pain. Studies are needed to investigate mechanisms underlying pain sensitivity differences between adults with and without postamputation pain.

Objective: Among adults with persistent post-amputation pain, increased amputated-region pain sensitivity may reflect peripheral sensitization or indicate underlying central sensitization. To determine whether underlying central sensitization may contribute to increased pain sensitivity in this population, this study compared clinical signs and symptoms associated with central sensitization between adults with post-amputation pain who demonstrate or lack increased amputated-region sensitivity (as compared to reference data).